A randomized controlled trial of home monitoring versus hospitalization for mild non-alcoholic acute interstitial pancreatitis: A pilot study

Abstract Background/Objectives Acute pancreatitis (AP) is a disease typically requiring in-hospital treatment. We conducted a trial to assess the feasibility of early discharge from the hospital for patients with mild non-alcoholic acute pancreatitis (NAAP). Methods Eighty-four patients with mild NA...

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Bibliographic Details
Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2014-05, Vol.14 (3), p.174-178
Main Authors: İnce, Ali Tüzün, Senturk, Hakan, Singh, Vikesh K, Yildiz, Kemal, Danalioğlu, Ahmet, Çinar, Ahmet, Uysal, Ömer, Kocaman, Orhan, Baysal, Birol, Gürakar, Ahmet
Format: Article
Language:English
Subjects:
Abdomen
Acute Disease
Adult
Aged
Aged, 80 and over
Comorbidity
Disease
Endocrinology & Metabolism
Feasibility Studies
Female
Follow-Up Studies
Gastroenterology and Hepatology
Heart attacks
Home Care Services
Hospitalization
Hospitals
Humans
Logistic Models
Male
Middle Aged
Mortality
Pain
Pancreas
Pancreatitis - diagnosis
Pancreatitis - therapy
Patient Readmission
Pilot Projects
Prospective Studies
Severity of Illness Index
Statistical analysis
Treatment Outcome
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Summary:Abstract Background/Objectives Acute pancreatitis (AP) is a disease typically requiring in-hospital treatment. We conducted a trial to assess the feasibility of early discharge from the hospital for patients with mild non-alcoholic acute pancreatitis (NAAP). Methods Eighty-four patients with mild NAAP were randomized to home or hospital groups after a short hospital stay (≤24 h). AP was defined by the revised Atlanta criteria. Mild AP was defined as an Imrie score≤5 and a harmless acute pancreatitis score (HAPS)≤2 in the first 24-h of presentation. A nurse visited all patients in the home group on the 2nd, 3rd and 5th days. All patients presented for follow-up in clinic on the 7th, 14th, and 30th days. The primary outcome was the time to resolution of pain. Secondary outcomes evaluated included time to resumption of an oral diet, 30 day hospital readmission rate as well as the total costs associated with either approach to care. Results There was no difference between the groups with regards to demographics, prognostic severity scores, symptoms, and biliary findings. No patients developed organ failure, pancreatic necrosis, or died in either group. Time to the resolution of pain and resumption of solid food intake were similar. Three (3.6%) patients required readmission within 30 days, 1 from home and 2 from the hospital groups. The total cost was significantly less in home group ($139 ± 73 vs. $951 ± 715, p  
ISSN:1424-3903
1424-3911
DOI:10.1016/j.pan.2014.02.007